心源性脑栓塞和大动脉粥样硬化性脑梗死患者自发性出血性转化的发生及相关因素分析

Incidence and risk factors of spontaneous hemorrhagic transformation in cardioembolism and large artery atherosclerotic infarction

收集150例心源性脑栓塞（CE）和370例大动脉性粥样硬化性脑梗死（LAA）患者的临床资料,分析自发性出血性转化（HT）的发生及危险因素.结果显示,CE后HT发生率为29.3％,显著高于LAA的9.7％（P＜0.05）;梗死面积大、入院时美国国立卫生院神经功能缺损评分（NIHSS）高、随机血糖水平是影响CE患者HT的危险因素（OR值分别为3.92、2.96、1.45）;梗死面积大、低水平LDL-C、入院时NIHSS高是LAA患者HT的独立危险因素（OR值分别为4.86、2.42、1.42）.提示HT在CE患者后更常见;CE和LAA患者HT的危险因素不完全相同.

To explore the incidence and risk factors for spontaneous hemorrhagic transformation （HT） of cardioembolism （CE,n =150） and large artery atherosclerotic infarction （LAA,n =370）.The incidence of HT was 29.3% in CE.And it was significantly higher than 9.7% （P 〈0.05）.Infarct size,low-density lipoprotein-cholesterol （LDL-C） and admission National Institutes of Health Stroke Scale （NIHSS） score were independent predictors of spontaneous hemorrhagic transformation in LAA.OR values were 3.92,2.96 and 1.45 respectively.Infarct size,admission NIHSS score and random blood glucose level were independent predictors of spontaneous hemorrhagic transformation in CE.OR values were 4.86,2.42 and 1.42 respectively.As compared with LAA,CE was more prone to HT.LAA and CE-related factors of hemorrhagic transformation are not completely identical.